Primary Infection CNS Events Study (PISCES)

In the setting of primary HIV infection (within six months of acquisition), some individuals develop neurological signs and symptoms, and HIV can be detected in cerebrospinal fluid (CSF) in virtually all of those infected. The mechanism of this initial neuroinvasion - as well as its significance for the natural history of systemic infection and the ultimate development of neurological disorders - is poorly understood. It is thought that host responses of immune activation and inflammation are largely responsible for tissue injury. By examining the interplay between virus and host immune response early in HIV infection, we hope to gain insight into migitgating or reversing neuronal and synaptic injury. The primary goal of PISCES, a study conducted in San Francisco, CA, USA, was to longitudinally define CNS host responses and viral features during primary HIV infection through serial clinical, CSF, and MRI/MRS analyses. Study of CSF allows for the analysis of host CNS responses to infection, as well as characterization of potentially distinct populations of the virus residing in the CNS. This study has focused on understanding viral characteristics in primary infection to examine patterns of viral dynamics, mechanisms of inter-compartmental exchange, and time course of establishment of independent infection in the CNS. This study has been completed, but samples and data are available for ongoing investigations.

1R01MH081772 (PI Spudich) The Neuropathobiology of Primary HIV-1 Infection

R21 MH099979-01 (PI Spudich/Ances) Structural Neuroimaging Markers in Primary HIV Infection

K23MH74466 (PI Spudich) Central Nervous System Events in Primary HIV-1 Infection

University of California, San Francisco (USA)

University of Gothenburg (Sweden)

University of Milan (Italy)

University of North Carolina, Chapel Hill (USA)

Washington University in St. Louis (USA)